Psychological distress as a correlate of a biologically confirmed STI, risky sexual practices, self-efficacy and communication with male sex partners in African-American female adolescents

Author: Seth Puja  

Publisher: Routledge Ltd

ISSN: 1465-3966

Source: Psychology, Health and Medicine, Vol.14, Iss.3, 2009-05, pp. : 291-300

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Abstract

Previous research has established the association between psychosocial factors and risky sexual behaviour. However, few studies have examined the relationship between psychological distress and sexually transmitted infection (STI)/HIV-associated behaviours in African-American youth. The present study examined the association of psychological distress with STI/HIV-risk behaviour and psycho-social mediators of HIV-preventive behaviours. A sample of 715 African-American female adolescents, 15-21 years old, completed an audio computer assisted self-interviewing (ACASI) assessing sociodemographics, psychological distress, self-efficacy, communication and STI/HIV-associated sexual behaviours. Participants also provided self-collected vaginal swab specimens, which were assayed for STIs. High levels of psychological distress were defined as having a score of ≥7 on the eight-item Centre for Epidemiological Studies-Depression Scale. The overall prevalence of high levels of psychological distress was 44.5%. Logistic regression analyses revealed that adolescents with high psychological distress, relative to those with low psychological distress, were more likely to have a biologically confirmed STI (adjusted odd ratio (AOR) = 1.40), use condoms inconsistently (AOR = 1.50), not use condoms during their last casual sexual encounter (AOR = 1.89), have sex while high on alcohol or drugs (AOR = 1.47), have male sexual partners with concurrent female sexual partners (AOR = 1.98), have low condom use self-efficacy (AOR = 1.54), partner sexual communication self-efficacy (AOR = 1.77), refusal self-efficacy (AOR = 2.05) and be more fearful of communicating with their partners (AOR = 1.98). These findings, although preliminary, could be used to inform HIV intervention programs and physicians/clinicians providing regular health care maintenance to African-American female adolescents engaging in risky sexual behaviour.

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